Autoimmune encephalitis: proposed recommendations for symptomatic and long-term management.

Journal Article (Journal Article;Review)

The objective of this paper is to evaluate available evidence for each step in autoimmune encephalitis management and provide expert opinion when evidence is lacking. The paper approaches autoimmune encephalitis as a broad category rather than focusing on individual antibody syndromes. Core authors from the Autoimmune Encephalitis Alliance Clinicians Network reviewed literature and developed the first draft. Where evidence was lacking or controversial, an electronic survey was distributed to all members to solicit individual responses. Sixty-eight members from 17 countries answered the survey. The most popular bridging therapy was oral prednisone taper chosen by 38% of responders while rituximab was the most popular maintenance therapy chosen by 46%. Most responders considered maintenance immunosuppression after a second relapse in patients with neuronal surface antibodies (70%) or seronegative autoimmune encephalitis (61%) as opposed to those with onconeuronal antibodies (29%). Most responders opted to cancer screening for 4 years in patients with neuronal surface antibodies (49%) or limbic encephalitis (46%) as opposed to non-limbic seronegative autoimmune encephalitis (36%). Detailed survey results are presented in the manuscript and a summary of the diagnostic and therapeutic recommendations is presented at the conclusion.

Full Text

Duke Authors

Cited Authors

  • Abboud, H; Probasco, J; Irani, SR; Ances, B; Benavides, DR; Bradshaw, M; Christo, PP; Dale, RC; Fernandez-Fournier, M; Flanagan, EP; Gadoth, A; George, P; Grebenciucova, E; Jammoul, A; Lee, S-T; Li, Y; Matiello, M; Morse, AM; Rae-Grant, A; Rojas, G; Rossman, I; Schmitt, S; Venkatesan, A; Vernino, S; Pittock, SJ; Titulaer, M; Autoimmune Encephalitis Alliance Clinicians Network,

Published Date

  • March 1, 2021

Published In

PubMed ID

  • 33649021

Pubmed Central ID

  • PMC8292591

Electronic International Standard Serial Number (EISSN)

  • 1468-330X

Digital Object Identifier (DOI)

  • 10.1136/jnnp-2020-325302

Language

  • eng

Conference Location

  • England